首页|急性Stanford A型主动脉夹层的临床带教策略

急性Stanford A型主动脉夹层的临床带教策略

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急性Stanford A型主动脉夹层是心血管外科的危急重症,病情凶险,进展快速,临床表现和主动脉夹层撕裂的范围及程度相关,因而误诊率较高.此类患者一经确诊,尽早进行外科手术是成功救治的唯一途径.兰州大学第一医院是一家三级甲等教学医院,每年收治急诊及外院转诊的急性Stanford A型主动脉夹层约 100 例.对于首诊医师而言,如何进行快速正确的诊断、鉴别诊断、并完善术前相关准备,需要在熟练掌握理论知识的基础上,进行临床经验的积累和总结.文章针对外科规范化培训的医师、住院医师及进修医师,就近年来在心血管外科临床带教的教学体会,从急性Stanford A型主动脉夹层的正确诊断(症状和体征、人群分布特点、时间生物模式及辅助检查几个方面)、鉴别诊断及术前准备等方面进行总结,提高初学者对该病的临床辨别能力、初步救治能力及转诊能力,进而提高临床医师对此类患者的整体救治能力,尽可能减少漏诊和误诊.
Clinical Teaching Strategies for Acute Stanford Type A Aortic Dissection
Acute Stanford type A aortic dissection is a critical and severe disease in cardiovascular surgery.The disease is dangerous and progresses rapidly.The clinical manifestations are related to the scope and degree of aortic dissection tear,so the misdiagnosis rate is high.Once such patients are diagnosed,early surgery is the only way to successfully treat them.The First Hospital of Lanzhou University is a tertiary class A teaching hospital,which receives about 100 cases of acute Stanford type A aortic dissection referred by emergency and other hospitals every year.For first-visit physicians,it is necessary to accumulate and summarize clinical experience on the basis of mastering theoretical knowledge on how to make rapid and correct diagnosis,differential diagnosis and improve preoperative preparation.This article in view of the surgical standardization training of physicians,resident physician,and training in the teaching experience of cardiovascular surgery clinical teaching,from the acute Stanford type A aortic dissection of the correct diagnosis,differential diagnosis and preoperative preparation,etc,improve the beginner of the disease clinical discrimination ability,preliminary treatment and referral,then improve the overall treatment ability of clinicians to such patients,as far as possible to reduce missed diagnosis and misdiagnosis.

Stanford type A aortic dissectionpreoperative diagnosisdifferential diagnosispreoperative preparationclinical teachingthe overall treatment

王玲、孙伟、张世明、刘瑞生

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兰州大学第一医院心外科麻醉室,甘肃 兰州 730000

兰州大学第一医院心血管外科,甘肃 兰州 730000

Stanford A型主动脉夹层 术前诊断 鉴别诊断 术前准备 临床教学 整体救治

甘肃省科技计划甘肃省科技计划

21JR1RA11022JR11RA037

2024

中国继续医学教育

中国继续医学教育

影响因子:2.564
ISSN:1674-9308
年,卷(期):2024.16(6)
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